Discharge is a handover — to you

By the time you are told you can go home, you may have been in the department for six hours, it may be two in the morning, and your main ambition is your own bed. Which is precisely when the most important information of the whole visit — what to do next and what to watch for — gets delivered, half-heard and swiftly forgotten.

Think of discharge as a handover of responsibility from the hospital to you. Like any handover, it goes better when you know which questions to ask.

Five questions to ask before you walk out

  1. "What do you think it is — or what have you ruled out?" Sometimes the answer is a firm diagnosis; often it is "the dangerous things are excluded, and here is the most likely explanation." Both are useful. Leaving without either is not.
  2. "Exactly what should bring me back?" Clinicians call this safety-netting, and it is the crown jewel of discharge advice. Get it specific — which symptoms, in what timeframe — and get it written down, on paper or typed into your phone there and then.
  3. "What do I do about medicines?" New prescriptions: what is it, how often, for how long, with food or not, and can a normal pharmacy dispense it tomorrow or must you collect it from the hospital tonight? Just as important: has anything you already take been stopped or changed?
  4. "Who follows this up, and how does that get arranged?" Does a clinic contact you, do you phone a number, or should you book with your GP? Vague answers evaporate — pin them down.
  5. "Is there anything I should avoid?" Driving, alcohol, work, sport, flying, getting a dressing wet — restrictions vary hugely by condition, and nobody volunteers them unless asked.

If your visit was overnight, note that some services around the hospital keep office hours — our overnight and weekend guide explains what runs around the clock and what does not.

The first day home

Eat, drink, sleep. Hospital visits are dehydrating, hungry, exhausting experiences. A meal, plenty of fluids and a proper sleep are genuinely part of the treatment. Clear the diary for at least a day.

Get the painkiller timing right. Ask when your last hospital dose was given so you do not accidentally double up. Two rules cover most trouble: never exceed eight 500 mg paracetamol tablets in 24 hours (and remember cold-and-flu remedies often contain hidden paracetamol), and skip ibuprofen entirely if you were told to — that instruction usually exists for a reason, such as a recent head injury or a sensitive stomach. Codeine-type painkillers cause drowsiness and constipation; no driving while drowsy.

Run the watch-list. Whatever safety-net symptoms you were given, actively check for them rather than waiting for them to announce themselves. Carers looking after someone else should set phone alarms. Head-injury patients need waking and checking overnight — the specifics are in our head injuries guide.

The first week

Loop in your GP. The hospital does send your GP a discharge summary, but it can lag by days. A quick message through your surgery's online system — "attended A&E on Tuesday, started on X, told to arrange Y" — closes the gap. This matters most when antibiotics, blood thinners or mental-health medicines were started, or when a test result was still pending as you left, because pending results land on your GP's desk.

Care for any wound. Stitched, glued or strip-closed cuts want to stay clean and dry for the first two days. You should know the removal plan before leaving — stitches typically come out after three to fourteen days depending on where they are (facial ones earliest), usually at your GP practice, while glue and dissolvable stitches simply disappear on their own. The infection signs to know by heart: redness that spreads outward, growing pain after day two (wounds should hurt less each day, not more), warmth, swelling, pus, or a temperature. Any of those: same-day advice, via your GP or 111.

Sort the paperwork. You can self-certify for the first seven calendar days off work — no note needed. For anything longer, the hospital can issue a fit note covering the period its clinicians advised you were unfit, and after that fit notes come from your GP practice. If a fracture clinic, outpatient referral or scan was promised and a week passes with silence, chase it — ring the number on your paperwork or ask PALS at the hospital to track it down. Appointments do occasionally fall through administrative cracks, and the patient who phones is the patient who gets rebooked.

Going back: when, and without guilt

Return to the emergency department if:

  • A safety-net symptom appears — this is exactly what the list was for
  • You are trending worse when you were told to expect better
  • A new medicine triggers a severe rash, facial swelling or breathing trouble
  • You cannot keep fluids or essential tablets down
  • Something feels seriously wrong in a way you cannot articulate — that instinct has value

You need no referral, no appointment and no permission to walk back in, and returning is not an admission of fussiness. Emergency staff consistently say the same thing: they would far rather recheck ten people who turned out fine than miss the one who was not. If the return trip is concerning-but-not-urgent, a glance at live waiting times helps you pick the calmest department; if it is urgent, nearest wins.

For the things that do not need A&E — lingering questions about the diagnosis, ongoing pain management, minor side effects, fit notes, non-crisis mental-health follow-up — your GP is the right door, and 111 covers the gaps when the surgery is shut.

Two things people rarely mention

You can get your notes. Everything from your visit — observations, test results, the clinician's reasoning — is your data, and a subject access request to the hospital's records team gets you a copy free of charge. It is worth having before specialist appointments, for insurance claims, or simply to understand a blurry night. Our rights in A&E guide explains the process.

The wobble afterwards is normal. A frightening symptom, a chaotic waiting room, bad news for the patient on the next trolley — emergency visits can leave an emotional residue of jumpiness, tearfulness or exhaustion that surfaces days later. Give it air: talk to someone. If it has not eased after a couple of weeks, or it is disturbing sleep and daily life, your GP can help — and our mental health emergencies guide covers support that is available immediately if things feel urgent.

The short version

  • Before leaving: get the working diagnosis, written return-symptoms, medicine instructions, the follow-up plan and any restrictions
  • First 24 hours: rest, fluids, careful painkiller timing, active symptom-watching
  • First week: message your GP, mind the wound, chase any promised appointment that has not materialised
  • Go back for safety-net symptoms, deterioration or drug reactions — freely and without embarrassment
  • GP and 111 handle everything that is important but not urgent